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Who essential medicine concept

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Who essential medicine concept Who essential medicine concept Presentation Transcript

  • WHO concept of essential medicines Dr. Gyanendra Raj Joshi PharmD, RPh
  • Rational behind Essential Medicine List • Indiscriminate marketing of drugs without considering the health needs • Access of people living in rural areas to drugs • For poor and disadvantaged medicines are : – Unavailable – Unaffordable – Unsafe – Improperly used
  • • The concept of essential medicines A limited range of carefully selected essential medicines leads to better health care, better drug management, and lower costs. • Definition of essential medicines Essential medicines are those that satisfy the priority health care needs of the population.
  • • Essential medicines are intended to be available within the context of functioning health systems – at all times – in adequate amounts, – in the appropriate dosage forms, – with assured quality and adequate information and – at a price the individual and the community can afford.
  • Advantages • • • • • • Limited range High Quality care Better management of medicines More cost effective use of resources Real health gains Increased public confidence
  • • 1977 First Model list published, ± 200 active substances • List is revised every two years by WHO Expert Committee • Latest list in March 2011 (17th edition) containing 350 drugs • 3rd WHO Model List of Essential Medicines for Children
  • • The core list presents a list of minimum medicine needs for a basic health‐care system, listing the most efficacious, safe and cost‐effective medicines for priority conditions. • The complementary list presents essential medicines for priority diseases, for which specialized diagnostic or monitoring facilities, and/or specialist medical care, and/or specialist training are needed.
  • Selection of essential medicines • Two steps: – Market approval based on efficacy , safety and quality. – Evaluation based on comparison leading to a list for different levels of care.
  • • Factors such as – Pattern of prevalent disease, – Treatment facility, – Training and experience of available personnel, – Financial resources – Genetic , demographic and environmental factors.
  • Selection Criteria • • • • • Evidence of efficacy and safety Relative cost effectiveness Pharmacokinetics Availability Desired dosage form, bioavailability and stability ensured • Single compounds , in some cases fixed dose combinations
  • The Essential Medicines Target National list of essential medicines Registered medicines All the drugs in the world Levels of use S CHW dispensary Health center Hospital Referral hospital Private sector S Supplementary specialist medicines
  • Clinical guidelines and a list of essential medicines lead to better prevention and care List of common diseases and complaints Treatment choice Treatment guidelines Essential medicines list / National formulary Training and Supervision Financing and Supply of drugs Prevention and care
  • Practical applications • Basic and in service training of health care providers • Public sector procurement and distribution • Medicine benefits as part of health insurance • Drug donations and international aid • Monitoring systems on availability and pricing • Public education
  • Key policy issues • Access depending on : rational selection, affordable prices , sustainable financing and reliable health systems • Selection linked to standard clinical guidelines • Policies for procurement and supply and health insurance • Systematic and transparent procedure